The Appellate Division of the New Jersey Superior Court held that a Medicaid recipient’s interest in property held with her husband as tenants by the entirety was part of her estate under the state’s Medicaid statute and thus subject to a Medicaid lien. Forest v. Div. of Med. Assistance & Health Servs., No. A-1344-24, 2026 WL 772366 (N.J. Super. Ct. App. Div. Mar. 19, 2026).
Clerveaux and Philomene Benoit held a parcel of real property as tenants by the entirety. Philomene was a Medicaid beneficiary from 2003 to 2012. During that time, New Jersey’s Medicaid program expended $415,501.30 on her behalf for medical care and services. According to the estate recovery information system of New Jersey’s Division of Medical Assistance and Health Services (Division), the Division sent several notices of its claim of a Medicaid lien to the address of the property following Philomene’s death in 2012. In 2013, the information system was updated to show that Philomene had a surviving spouse.
In 2017, Clerveaux died. In April 2019, the executor of Philomene’s estate sent a letter to the Division inquiring about the status of the Medicaid lien and acknowledging that she had been informed that a lien may be placed on the home. Several days later, the Division sent a letter to the executor stating that it was asserting a claim against Philomene’s estate for the amount expended on her behalf and was filing a lien pursuant to section 30:4D-7.2(a) of the New Jersey Statutes Annotated. In May 2019, the Division sent the executor a copy of the lien claim it had docketed in the superior court referencing the amount expended on Philomene’s behalf and the property.
In August 2024, Mary Forest and Tarketia Ajayi, beneficiaries under Clerveaux’s will, filed a complaint against the Division seeking a declaration that the lien was legally ineffective against his estate, the property, and the proceeds from the sale of the property. The court denied their application. Mary and Tarketia appealed.
The Appellate Division of the New Jersey Superior Court reviewed de novo the trial court’s interpretation of the New Jersey and federal Medicaid statutes. The court noted that federal Medicaid law requires that states enact estate recovery provisions as part of their medical assistance plans. In New Jersey, the Division is authorized by section 30:4D-7.2(a) of the New Jersey Statutes Annotated to file a lien against the estate of a Medicaid recipient for all services received after reaching age 55. Under federal law, the decedent’s estate must include at least all assets included in the estate under state probate law and can include “any other real and personal property and other assets in which the individual had any legal title or interest at the time of death” and assets conveyed to a survivor through “joint tenancy, tenancy in common, survivorship, . . . or other arrangement.” 42 U.S.C. § 1396p(b)(4)(B). Section 30:4D-7.2(a)(3) defines estate to include “other real and personal property and other assets in which the recipient had any legal title or interest at the time of death, to the extent of that interest, including assets conveyed to a survivor, heir or assign of the recipient through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement.”
The court found that under New Jersey law, Philomene’s estate included an interest in property she held at her death, which included her interest in the property held as tenants by the entirety. The court determined that, although the state and federal statutes did not explicitly mention tenancies by the entirety, their definitions of estate “clearly” encompassed them. Forest v. Div. of Med. Assistance & Health Servs., No. A-1344-24, 2026 WL 772366, at *4 (N.J. Super. Ct. App. Div. Mar. 19, 2026). Further, New Jersey’s Medicaid regulations expressly authorize liens on property held as a tenancy by the entirety. N.J. Admin. Code § 10:49-14.1(m). Consequently, property held as a tenancy by the entirety was not uncollectible under the federal or state Medicaid estate recovery statutes. The fact that Clerveaux survived Philomene did not preclude the Division from enforcing a Medicaid lien; rather, it affected only the timing of its efforts to enforce the lien and recover the amounts expended on Philomene’s behalf. Under federal law, states may recover Medicaid benefits from the recipient’s estate—including property held as a tenancy by the entirety at their death—but must wait until after the death of the recipient’s surviving spouse.
The court also rejected Mary and Tarketia’s assertion that the Division’s lien was unenforceable because it was untimely. Pursuant to New Jersey regulations, the Division was required to file a claim within three years of receiving written notice from the personal representative of the estate or other interested party. The regulation did not require it to be filed in court, docketed, or recorded within that time, and the court declined to read such a requirement into the regulation. Therefore, the Division was not precluded from enforcing the lien because it had waited until 2024 to docket it.
Further, the court ruled that the lien did not infringe Clerveaux’s constitutional property rights: Clerveaux did not challenge the lien before his death, and the trial court had declined to address the issue because Mary and Tarketia had not previously raised it. The court noted that it typically did not consider issues not presented to the trial court, but it went on to find that the lien was not an unconstitutional taking of Clerveaux’s property without just compensation; rather, it was an effort to obtain reimbursement of Medicaid benefits paid on Philomene’s behalf through her (not Clerveaux’s) interest in the property. Therefore, the court affirmed the trial court’s judgment.
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